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1. Wang HY, Chen MJ, Yang TL, Chang MC, Chan YJ: Carcinoid tumor of the duodenum and accessory papilla associated with polycythemia vera. World J Gastroenterol; 2005 Jun 28;11(24):3794-6
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  • [Title] Carcinoid tumor of the duodenum and accessory papilla associated with polycythemia vera.
  • Carcinoid tumors have been reported in a wide range of organs but most frequently involve the gastrointestinal tract; however, duodenal carcinoid tumors are rare.
  • The biopsy taken showed a carcinoid tumor.
  • He received periodic phlebotomy and hydroxyurea treatment.
  • The possible origin of UGI bleeding by a duodenal carcinoid tumor, although rare, should be considered.
  • There has been one case report of a duodenal carcinoid tumor that involved accessory papilla of the pancreas divisum and one case report of metastatic carcinoid tumor associated with polycythemia vera.
  • It is different in our patient as compared with the latter report, which mentioned a polycythemia vera patient who was found to have a metastatic carcinoid in the 17 years follow-up period.
  • Chemotherapy had been given before the carcinoid tumor was revealed.
  • Our patient had no previous chemotherapy for polycythemia vera before he was found to have duodenal carcinoid tumor; this excludes the possibility of chemotherapy induced carcinoid tumor, although it had been suspected in the previous report.
  • [MeSH-major] Carcinoid Tumor / complications. Duodenal Neoplasms / complications. Pancreatic Ducts / pathology. Polycythemia Vera / complications


2. Arvidsson Y, Bergström A, Arvidsson L, Kristiansson E, Ahlman H, Nilsson O: Hypoxia stimulates CXCR4 signalling in ileal carcinoids. Endocr Relat Cancer; 2010 Jun;17(2):303-16
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  • Tumour hypoxia is associated with increased metastatic potential and resistance to radiotherapy and chemotherapy.
  • Ileal carcinoids are usually metastatic at the time of diagnosis and respond poorly to chemotherapy.
  • The aim of this study was to investigate the extent of hypoxia in ileal carcinoids and the response of tumour cells to induced hypoxia.
  • All hypoxic markers were shown to be highly expressed in localized areas of the tumours irrespective of tumour location or stage.
  • Global gene expression profiling of GOT1 carcinoid cells revealed a marked response to hypoxia.
  • Expression of genes related to epithelial-to-mesenchymal transition and development was altered including increased expression of the C-X-C chemokine receptor type 4 (CXCR4), an important regulator of invasive growth and metastasis formation.
  • High expression of CXCR4 was confirmed by immunohistochemistry in tumour biopsies.
  • Stimulation of GOT1 cells by the CXCR4 ligand, CXCL12 (stromal cell-derived factor 1 (SDF-1)), activated the mitogen-activated protein kinase (MAPK) p42/44 signalling pathway and increased tumour cell migration.
  • Signalling through the CXCL12-CXCR4 axis may contribute to the metastatic potential of ileal carcinoids.
  • Targeting of HIFs and/or the CXCR4 signalling pathway may offer new therapeutic strategies for carcinoid tumour disease.
  • [MeSH-major] Basic Helix-Loop-Helix Transcription Factors / metabolism. Carcinoid Tumor / metabolism. Hypoxia-Inducible Factor 1, alpha Subunit / metabolism. Ileal Neoplasms / metabolism. Receptors, CXCR4 / metabolism

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  • (PMID = 20071457.001).
  • [ISSN] 1479-6821
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Basic Helix-Loop-Helix Transcription Factors; 0 / CXCR4 protein, human; 0 / Chemokine CXCL12; 0 / HIF1A protein, human; 0 / Hypoxia-Inducible Factor 1, alpha Subunit; 0 / Receptors, CXCR4; 0 / Vascular Endothelial Growth Factors; 0 / endothelial PAS domain-containing protein 1; EC 2.7.11.24 / Mitogen-Activated Protein Kinases; EC 4.2.1.1 / Carbonic Anhydrases
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3. Hamada T, Tanaka M, Hashimoto Y, Yamauchi M, Shigeoka N, Shima H, Nakai K, Suenaga K, Nakayama H: [A case of endocrine cell carcinoma of the ileum: sonographic findings and clinical outcome]. Nihon Shokakibyo Gakkai Zasshi; 2006 Oct;103(10):1139-45
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  • A 56-year-old man, who had been complaining of diarrhea for several months, was admitted for further examination of a hepatic tumor.
  • A needle biopsy of the hepatic tumor suggested metastatic carcinoid tumor.
  • The primary tumor was found in the ileum by extracorporeal sonographic examination and a barium meal study.
  • We performed a partial excision of the ileum, lymph node resection, wedge biopsy of the liver, and catheterization from the right iliac artery to the hepatic artery for intraarterial chemotherapy.
  • [MeSH-major] Carcinoid Tumor / ultrasonography. Ileal Neoplasms / ultrasonography

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  • (PMID = 17023756.001).
  • [ISSN] 0446-6586
  • [Journal-full-title] Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology
  • [ISO-abbreviation] Nihon Shokakibyo Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 23
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4. Corleto VD, Angeletti S, Schillaci O, Marignani M, Caratozzolo M, Panzuto F, Annibale B, Delle Fave G: Long-term octreotide treatment of metastatic carcinoid tumor. Ann Oncol; 2000 Apr;11(4):491-3
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  • [Title] Long-term octreotide treatment of metastatic carcinoid tumor.
  • The optimal dosage of somatostatin analogs for the long-term control of carcinoid tumors has not yet been established.
  • Receptor alterations induced during long term treatment with somatostatin analogs have lead to consecutive drug dosage increases in order to control carcinoid disease.
  • In this report, we describe the rapid and effective control of tumor in a patient with metastatic carcinoid treated for nine years with a single daily dose of octreotide based on tumor marker levels.
  • We suggest that a single daily dose of octreotide strictly related to tumor marker secretion, could have played a role in the effective long-term therapy by avoiding the phenomenon of somatostatin receptor desensitisation.

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  • (PMID = 10847473.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Receptors, Somatostatin; RWM8CCW8GP / Octreotide
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5. Tetzlaff ED, Ajani JA: Oxaliplatin-based chemotherapy for the treatment of a metastatic carcinoid tumor. Int J Gastrointest Cancer; 2005;36(1):55-8
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  • [Title] Oxaliplatin-based chemotherapy for the treatment of a metastatic carcinoid tumor.
  • Carcinoid tumors are rare and often resistant to chemotherapy agents.
  • Although a slow-growing tumor, patients can have significant morbidity associated with carcinoid syndrome and patients will often die as a result of tumor progression.
  • We report the first case of a patient with a metastatic carcinoid tumor to respond to an oxaliplatin-based regimen.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoid Tumor / drug therapy
  • [MeSH-minor] Fluorouracil / administration & dosage. Humans. Infusions, Intravenous. Male. Middle Aged. Neoplasm Metastasis. Organoplatinum Compounds / administration & dosage. Treatment Outcome

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  • (PMID = 16227636.001).
  • [ISSN] 1537-3649
  • [Journal-full-title] International journal of gastrointestinal cancer
  • [ISO-abbreviation] Int J Gastrointest Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Organoplatinum Compounds; 04ZR38536J / oxaliplatin; U3P01618RT / Fluorouracil
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6. Arnold R, Wied M, Behr TH: Somatostatin analogues in the treatment of endocrine tumors of the gastrointestinal tract. Expert Opin Pharmacother; 2002 Jun;3(6):643-56
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  • [Title] Somatostatin analogues in the treatment of endocrine tumors of the gastrointestinal tract.
  • Somatostatin and its long-acting analogues have been introduced for the treatment of endocrine tumours of the gastrointestinal tract as they have been shown to effectively control symptoms resulting from excessive hormone release in patients with carcinoid, Verner-Morrison and glucagonoma syndromes.
  • The antiproliferative potency of somatostatin and its analogues in vitro and in experimental tumour models prompted a number of studies in patients with metastatic endocrine tumours that are generally unresponsive to conventional chemotherapeutic protocols.
  • Stabilisation of tumour growth lasting for months to a few years was the most favourable result, occurring in 30 - 70% of patients.
  • Radioligand therapy based on 111Indium, 90Yttrium and 177Lutetium coupled to somatostatin analogues via bifunctional chelators is currently under investigation with promising data concerning long-lasting control of symptoms and tumour growth from Phase I trials.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Gastrointestinal Neoplasms / drug therapy. Neoplasms, Glandular and Epithelial / drug therapy. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use
  • [MeSH-minor] Animals. Clinical Trials as Topic. Drug Therapy, Combination. Humans. Interferon-alpha / therapeutic use. Octreotide / therapeutic use. Peptides, Cyclic / therapeutic use. Radioisotopes / therapeutic use. Receptors, Somatostatin / drug effects

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  • [ErratumIn] Expert Opin Pharmacother. 2002 Jul;3(7):1029
  • (PMID = 12472080.001).
  • [ISSN] 1465-6566
  • [Journal-full-title] Expert opinion on pharmacotherapy
  • [ISO-abbreviation] Expert Opin Pharmacother
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Interferon-alpha; 0 / Peptides, Cyclic; 0 / Radioisotopes; 0 / Receptors, Somatostatin; 118992-92-0 / lanreotide; 51110-01-1 / Somatostatin; RWM8CCW8GP / Octreotide
  • [Number-of-references] 134
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7. Dominguez S, Denys A, Madeira I, Hammel P, Vilgrain V, Menu Y, Bernades P, Ruszniewski P: Hepatic arterial chemoembolization with streptozotocin in patients with metastatic digestive endocrine tumours. Eur J Gastroenterol Hepatol; 2000 Feb;12(2):151-7
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  • [Title] Hepatic arterial chemoembolization with streptozotocin in patients with metastatic digestive endocrine tumours.
  • BACKGROUND: Hepatic arterial chemoembolization (CE) with anthracyclines is an effective treatment for progressive liver metastases of digestive endocrine tumours.
  • Streptozotocin (STZ) is widely used for systemic chemotherapy, but its efficacy by the hepatic arterial route has not been evaluated.
  • All patients had progressive liver metastases from either a carcinoid tumour (eight patients) or an islet cell carcinoma (ICC) (seven patients) that had increased in size (> or = 25%) before CE.
  • Five patients had the carcinoid syndrome.
  • RESULTS: An objective response was achieved in 8/15 patients (53%; median duration of 10.5 months) whatever the primary tumour (carcinoid or ICC).
  • The carcinoid syndrome disappeared in 3/5 patients for 10, 11 and 17 months, respectively.
  • CONCLUSION: Hepatic arterial chemoembolization with STZ is an effective treatment for patients with liver metastases caused by digestive endocrine tumours.
  • [MeSH-major] Antibiotics, Antineoplastic / administration & dosage. Carcinoid Tumor / therapy. Carcinoma, Islet Cell / therapy. Chemoembolization, Therapeutic. Intestinal Neoplasms / pathology. Liver Neoplasms / therapy. Streptozocin / administration & dosage
  • [MeSH-minor] Adult. Aged. Female. Hepatic Artery. Humans. Male. Middle Aged. Prospective Studies. Tomography, X-Ray Computed. Treatment Outcome

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  • [CommentIn] Eur J Gastroenterol Hepatol. 2000 Feb;12(2):141-3 [10741925.001]
  • (PMID = 10741928.001).
  • [ISSN] 0954-691X
  • [Journal-full-title] European journal of gastroenterology & hepatology
  • [ISO-abbreviation] Eur J Gastroenterol Hepatol
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] ENGLAND
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 5W494URQ81 / Streptozocin
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8. Kasi VS, Ahsanuddin AN, Gilbert C, Orr L, Moran J, Sorrell VL: Isolated metastatic myocardial carcinoid tumor in a 48-year-old man. Mayo Clin Proc; 2002 Jun;77(6):591-4
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  • [Title] Isolated metastatic myocardial carcinoid tumor in a 48-year-old man.
  • The mass, which involved the subvalvar right ventricular free wall, was resected and determined to be a metastatic carcinoid tumor by histologic and immunohistochemical analysis.
  • Further investigation revealed the presence of a midgut carcinoid tumor located within the terminal ileum, which was also resected surgically.
  • The patient recovered well after surgery and adjunctive chemotherapy.
  • To our knowledge, this is the first report of comprehensive nuclear and echocardiographic imaging, supplemented by surgical and pathologic findings, in an asymptomatic patient with isolated myocardial metastasis of an ileal carcinoid tumor.
  • [MeSH-major] Carcinoid Tumor / secondary. Heart Neoplasms / complications. Heart Neoplasms / secondary. Ileal Neoplasms / pathology. Ventricular Dysfunction, Right / etiology

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  • [ErratumIn] Mayo Clin Proc 2002 Dec;77(12):1396. Ahsanudin Arshad N [corrected to Ahsanuddin Arshad N]
  • (PMID = 12059131.001).
  • [ISSN] 0025-6196
  • [Journal-full-title] Mayo Clinic proceedings
  • [ISO-abbreviation] Mayo Clin. Proc.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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9. Molenaar JP, Baten A, Blokx WA, Hoogendam A: Development of carcinoid tumour in hormonally treated adenocarcinoma of the prostate. Eur Urol; 2009 Nov;56(5):874-7; quiz 876
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  • [Title] Development of carcinoid tumour in hormonally treated adenocarcinoma of the prostate.
  • We present the case of an 81-yr-old man with a prostatic adenocarcinoma and a metastatic carcinoid.
  • Simultaneous occurrence of hormonally treated adenocarcinoma of the prostate and a carcinoid has been described before.
  • The pathogenesis of this coincidence is largely unclear; however, androgen deprivation therapy might play a key role in neuroendocrine differentiation of adenocarcinoma cells.
  • Early recognition of the carcinoid syndrome is crucial, as surgical cure is not possible after metastasis.
  • [MeSH-major] Adenocarcinoma / drug therapy. Androgen Antagonists / therapeutic use. Anilides / therapeutic use. Antineoplastic Agents, Hormonal / therapeutic use. Carcinoid Tumor / pathology. Liver Neoplasms / pathology. Neoplasms, Multiple Primary. Nitriles / therapeutic use. Prostatic Neoplasms / drug therapy. Tosyl Compounds / therapeutic use
  • [MeSH-minor] Aged, 80 and over. Biopsy. Humans. Male. Malignant Carcinoid Syndrome / drug therapy. Positron-Emission Tomography. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use

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  • (PMID = 19171417.001).
  • [ISSN] 1873-7560
  • [Journal-full-title] European urology
  • [ISO-abbreviation] Eur. Urol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Androgen Antagonists; 0 / Anilides; 0 / Antineoplastic Agents, Hormonal; 0 / Nitriles; 0 / Tosyl Compounds; 51110-01-1 / Somatostatin; A0Z3NAU9DP / bicalutamide
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10. Hubalewska-Dydejczyk A, Szybiński P, Fröss-Baron K, Mikolajczak R, Huszno B, Sowa-Staszczak A: (99m)Tc-EDDA/HYNIC-octreotate - a new radiotracer for detection and staging of NET: a case of metastatic duodenal carcinoid. Nucl Med Rev Cent East Eur; 2005;8(2):155-6
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  • [Title] (99m)Tc-EDDA/HYNIC-octreotate - a new radiotracer for detection and staging of NET: a case of metastatic duodenal carcinoid.
  • We present a case of a 47-year-old man with disseminated duodenal carcinoid.
  • The patient had been operated due to the tumour mass detected in pancreatic head area.
  • Histopathology revealed carcinoid of the duodenal wall with local lymph node and liver metastases.
  • The patient was qualified for chemotherapy stopped due to severe leucopenia. (99m)Tc EDDA/HYNIC-octreotate scintigraphy was performed for staging and to determine SSTR status of the tumour before planned 90Y-DOTATATE therapy.
  • The multiple metastatic lesions were detected all over the body.
  • On the basis of SRS result the patient was qualified for 90Y-DOTA-TATE therapy.

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  • (PMID = 16437406.001).
  • [ISSN] 1506-9680
  • [Journal-full-title] Nuclear medicine review. Central & Eastern Europe
  • [ISO-abbreviation] Nucl Med Rev Cent East Eur
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Organotechnetium Compounds; 0 / Radiopharmaceuticals; 0 / technetium 99m EDDA-HYNIC-Tyr(3)-octreotide
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11. Bouvier N, Zengerling V, Halley A, Le Pennec V, Le Rochais JP, Madelaine J, Galateau-Salle F, Bergot E, Zalcman G: [Primitive metastasizing bronchial carcinoid with long survival]. Rev Mal Respir; 2007 Jan;24(1):63-8
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  • [Title] [Primitive metastasizing bronchial carcinoid with long survival].
  • [Transliterated title] Carcinoïde bronchique d'emblée multimétastatique et survie prolongée. Une entité anatomo-clinique peu connue: place de l'imagerie fonctionnelle.
  • BACKGROUND: Metastatic bronchial carcinoid tumours are rare but some patients have a prolonged survival.
  • OBSERVATION: A 57 year old patient was referred for dyspnoea on exertion revealing an upper left lobar tumour, with carcinoid syndrome.
  • The assessment enabled to find out a bronchial carcinoid tumour with liver and bone metastases, highlighted by positron-emission tomography and pentetreotide SPECT.
  • A chemotherapy proved to be ineffective and upper left lobectomy was carried out because of the risk of pulmonary atelectasis.
  • The patient was alive 44 months after diagnosis (56 months after first computed tomography).
  • CONCLUSION: Metastatic bronchial carcinoid tumours are rare.
  • They keep a metastatic potential, the histological type remaining the major prognosis factor.
  • Carcinoid syndrome is suggestive.
  • The assessment of extra-thoracic disease extent benefits by contribution of new functional imagery techniques such as the pentetreotide SPECT and positron-emission tomography.
  • The management is essentially symptomatic since there is no effective chemotherapy.
  • [MeSH-minor] Humans. Male. Middle Aged. Survivors. Time Factors

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  • (PMID = 17268367.001).
  • [ISSN] 0761-8425
  • [Journal-full-title] Revue des maladies respiratoires
  • [ISO-abbreviation] Rev Mal Respir
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
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12. Sun W, Lipsitz S, Catalano P, Mailliard JA, Haller DG, Eastern Cooperative Oncology Group: Phase II/III study of doxorubicin with fluorouracil compared with streptozocin with fluorouracil or dacarbazine in the treatment of advanced carcinoid tumors: Eastern Cooperative Oncology Group Study E1281. J Clin Oncol; 2005 Aug 1;23(22):4897-904
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  • [Title] Phase II/III study of doxorubicin with fluorouracil compared with streptozocin with fluorouracil or dacarbazine in the treatment of advanced carcinoid tumors: Eastern Cooperative Oncology Group Study E1281.
  • PURPOSE: Optimal treatments for metastatic carcinoid tumor remain undefined, and the role of chemotherapy for symptomatic patients with progressive disease is uncertain.
  • PATIENTS AND METHODS: Two hundred forty-nine patients with advanced carcinoid tumors were randomized to either doxorubicin with fluorouracil (FU/DOX) or streptozocin with fluorouracil (FU/STZ).
  • Patients crossed over to the dacarbazine (DTIC) treatment after disease progression following first-line treatment (either FU/DOX or FU/STZ), and 73 patients were assigned to one of these three treatments based on their previous treatment or on abnormal baseline cardiac or renal function.
  • The response rate of crossover DTIC treatment was 8.2%, with a median survival of 11.9 months.
  • Hematologic toxicities were the major treatment-related toxicities for both FU/DOX and FU/STZ, and mild to moderate renal toxicity was reported in 40 (34.8%) of 115 patients in the FU/STZ arm.
  • CONCLUSION: Response to all three treatment regimens were modest.
  • FU/STZ improved survival compared with the doxorubicin-based regimen, suggesting that the combination should be considered to be an active regimen of therapy when chemotherapy is judged to be an option for selected patients with carcinoid tumors.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoid Tumor / drug therapy

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  • (PMID = 16051944.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA13650; United States / NCI NIH HHS / CA / CA15488; United States / NCI NIH HHS / CA / CA21115; United States / NCI NIH HHS / CA / CA233818; United States / NCI NIH HHS / CA / CA66636
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Clinical Trial, Phase III; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 5W494URQ81 / Streptozocin; 80168379AG / Doxorubicin; U3P01618RT / Fluorouracil
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13. Meyers MO, Anthony LB, McCarthy KE, Drouant G, Maloney TJ, Espanan GD, Woltering EA: High-dose indium 111In pentetreotide radiotherapy for metastatic atypical carcinoid tumor. South Med J; 2000 Aug;93(8):809-11
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  • [Title] High-dose indium 111In pentetreotide radiotherapy for metastatic atypical carcinoid tumor.
  • We hypothesized that high-dose 111In-pentetreotide could be therapeutic in patients with somatostatin receptor-expressing tumors.
  • Our 35-year-old patient had atypical carcinoid tumor metastatic to cervical, supraclavicular, mediastinal, and mesenteric lymph nodes and to the liver and bone.
  • Chemotherapy had stabilized the disease but with severe gastrointestinal side effects.
  • After a diagnostic 111In-pentetreotide scan, the patient was given eight courses (180 mCi each) of 111In-pentetreotide therapy to selectively target somatostatin receptor-expressing tumor cells.
  • The patient had two additional courses of 111In-pentetreotide therapy (360 mCi each).
  • She died of the disease approximately 18 months after initiation of 111In-pentetreotide therapy.
  • [MeSH-major] Bone Neoplasms / radiotherapy. Bone Neoplasms / secondary. Carcinoid Tumor / radiotherapy. Carcinoid Tumor / secondary. Liver Neoplasms / radiotherapy. Liver Neoplasms / secondary. Lymphatic Metastasis / radiotherapy. Somatostatin / analogs & derivatives
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Etoposide / administration & dosage. Fatal Outcome. Female. Humans. Ifosfamide / administration & dosage. Receptors, Somatostatin / analysis. Receptors, Somatostatin / drug effects

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  • (PMID = 10963516.001).
  • [ISSN] 0038-4348
  • [Journal-full-title] Southern medical journal
  • [ISO-abbreviation] South. Med. J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Receptors, Somatostatin; 51110-01-1 / Somatostatin; 6PLQ3CP4P3 / Etoposide; G083B71P98 / pentetreotide; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
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14. Nakajima Y, Takagi H, Sohara N, Sato K, Kakizaki S, Nomoto K, Suzuki H, Suehiro T, Shimura T, Asao T, Kuwano H, Mori M, Nishikura K: Living-related liver transplantation for multiple liver metastases from rectal carcinoid tumor: a case report. World J Gastroenterol; 2006 Mar 21;12(11):1805-9
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  • [Title] Living-related liver transplantation for multiple liver metastases from rectal carcinoid tumor: a case report.
  • Colonoscopy revealed submucosal tumor in the rectum, which was considered the primary lesion.
  • Endoscopic mucosal resection followed by histopathological examination revealed that the tumor was carcinoid.
  • The resected margin of the tumor was positive for malignant cells.
  • Two courses to transcatheter arterial chemotherapy for liver metastasis were ineffective.
  • Accordingly, the rectal tumor and metastatic lymph nodes were surgically resected.
  • Liver transplantation should be considered as a treatment option even in advanced case of carcinoid metastasis to the liver.
  • We also discuss the literature on liver transplantation for metastatic carcinoid tumor.
  • [MeSH-major] Carcinoid Tumor / pathology. Liver Neoplasms / secondary. Liver Neoplasms / surgery. Liver Transplantation / methods. Rectal Neoplasms / pathology


15. Pectasides D, Glotsos J, Bountouroglou NG, Dadioti PA, Athanassiou AE: Primary carcinoid of the testis with metastases. Case report and review of the literature. J BUON; 2002 Apr-Jun;7(2):153-6
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  • [Title] Primary carcinoid of the testis with metastases. Case report and review of the literature.
  • Primary carcinoid of the testis is an extremely rare neoplasm, making up 0.23% of all testicular neoplasms.
  • We present a case of a 50-year-old man with a primary testicular carcinoid who developed lymph node and lung metastases 4 months after left inguinal orchidectomy.
  • Our case was not associated with testicular teratoma or carcinoid syndrome.
  • Vigorous efforts were done postoperatively to exclude the possibility of carcinoid tumor metastatic to the testis.
  • Our patient achieved a mixed response (lung metastases: complete response, lymph node metastases: partial response) with combined therapy that included chemotherapy (cisplatin, etoposide, ifosfamide, epirubicin), octreotide and radiotherapy to the metastatic lymph nodes.
  • We herein review the literature and discuss all the possibilities to explain the origin of carcinoid tumors of the testis.

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  • (PMID = 17577281.001).
  • [ISSN] 1107-0625
  • [Journal-full-title] Journal of B.U.ON. : official journal of the Balkan Union of Oncology
  • [ISO-abbreviation] J BUON
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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16. Sywak MS, Pasieka JL, McEwan A, Kline G, Rorstad O: 131I-meta-iodobenzylguanidine in the management of metastatic midgut carcinoid tumors. World J Surg; 2004 Nov;28(11):1157-62
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  • [Title] 131I-meta-iodobenzylguanidine in the management of metastatic midgut carcinoid tumors.
  • The management of metastatic neuroendocrine tumors incorporates multimodal therapy with surgery, biotherapy, and chemotherapy.
  • Tumor-targeted therapies using radiolabeled octreotide and metaiodobenzylguanidine (mIBG) represent a novel treatment approach.
  • The aim of this study was to evaluate the effectiveness of 131I-mIBG in the treatment of metastatic midgut carcinoid tumors. survival outcomes were assessed for patients treated at two regional cancer centers and then compared.
  • One center used 131I-mIBG routinely in the management of metastatic carcinoid tumors (center A), and the other did not use this modality (center B).
  • Only patients with histologically proven metastatic carcinoid tumor shown, or thought most likely, to be of midgut origin were included in the study.
  • During the period 1980 to 2002, a series of 58 patients from center A with metastatic carcinoid tumor arising from the midgut underwent multimodality therapy with the addition of 131I-mIBG.
  • The median dose of 131I-mIBG administered was 6751 MBq, and there was an average of 2.8 treatments per patient.
  • During the same period, 58 patients with metastatic carcinoid were treated at center B with similar multimodality therapy without the use of 131I-mIBG therapy.
  • Although retrospective in nature, this study suggests that the addition of 131I-mIBG therapy to the treatment protocol of patients with metastatic midgut carcinoid tumors prolongs survival.
  • [MeSH-major] 3-Iodobenzylguanidine / therapeutic use. Antineoplastic Agents / therapeutic use. Carcinoid Tumor / drug therapy. Intestinal Neoplasms / drug therapy
  • [MeSH-minor] Aged. Combined Modality Therapy. Female. Humans. Ileal Neoplasms / drug therapy. Ileal Neoplasms / pathology. Jejunal Neoplasms / drug therapy. Jejunal Neoplasms / pathology. Liver Neoplasms / secondary. Lymphatic Metastasis. Male. Middle Aged. Peritoneal Neoplasms / secondary. Retrospective Studies. Survival Analysis

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  • (PMID = 15490060.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 35MRW7B4AD / 3-Iodobenzylguanidine
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17. Bapat U, Mackinnon NA, Spencer MG: Carcinoid tumours of the larynx. Eur Arch Otorhinolaryngol; 2005 Mar;262(3):194-7
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  • [Title] Carcinoid tumours of the larynx.
  • The tumour histology and prognosis correlate closely.
  • The typical carcinoid tumours are well differentiated with a benign course.
  • Conservative surgery for local disease is the treatment and is associated with good survival.
  • The atypical carcinoid tumours are poorly differentiated with an aggressive course.
  • Response to radiotherapy and chemotherapy is poor.
  • The treatment of choice is adequate total excision of the lesion with neck dissection if there is clinical evidence of cervical lymphadenopathy and a careful follow-up so as to recognise and treat any metastatic spread.
  • [MeSH-major] Carcinoid Tumor / pathology. Laryngeal Neoplasms / pathology
  • [MeSH-minor] Aged. Combined Modality Therapy. Female. Humans. Male

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  • (PMID = 15164214.001).
  • [ISSN] 0937-4477
  • [Journal-full-title] European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
  • [ISO-abbreviation] Eur Arch Otorhinolaryngol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
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18. Katai M, Sakurai A, Inaba H, Ikeo Y, Yamauchi K, Hashizume K: Octreotide as a rapid and effective painkiller for metastatic carcinoid tumor. Endocr J; 2005 Apr;52(2):277-80
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  • [Title] Octreotide as a rapid and effective painkiller for metastatic carcinoid tumor.
  • Octreotide is one of the somatostatin analogue used for the treatment of endocrine tumors principally to suppress hormone secretion and to inhibit tumor growth.
  • We experienced a case with multiple endocrine neoplasia type 1 who small amount of octreotide dramatically relieved the lumber pain caused by metastatic bone tumor.
  • He had recurrent bronchial carcinoid tumors that metastasized to liver and bones.
  • Combination therapy of octreotide and interferon alpha-2b significantly reduced the size of metastatic liver tumors and inhibited further growth of metastatic bone tumors for the last 27 months.
  • The use of octreotide may be a good option for controlling pain by metastatic bone disease and combination therapy of octreotide and interferon alpha-2b is worth to try for patients with inoperable metastatic carcinoid tumor.
  • [MeSH-major] Analgesics / therapeutic use. Bronchial Neoplasms / physiopathology. Carcinoid Tumor / secondary. Octreotide / therapeutic use
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Back Pain / drug therapy. Bone Neoplasms / drug therapy. Bone Neoplasms / physiopathology. Bone Neoplasms / secondary. Humans. Interferon-alpha / therapeutic use. Liver Neoplasms / drug therapy. Liver Neoplasms / secondary. Male. Middle Aged. Multiple Endocrine Neoplasia Type 1. Recombinant Proteins

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  • (PMID = 15863961.001).
  • [ISSN] 0918-8959
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Analgesics; 0 / Interferon-alpha; 0 / Recombinant Proteins; 99210-65-8 / interferon alfa-2b; RWM8CCW8GP / Octreotide
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19. Shelat VG, Diddapur RK: Duodenal carcinoid: a rare cause of melaena in a cirrhotic patient. Singapore Med J; 2008 Aug;49(8):e198-201
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  • [Title] Duodenal carcinoid: a rare cause of melaena in a cirrhotic patient.
  • Metastatic disease has a poor prognosis.
  • These are indolent tumours and hence role of chemotherapy is limited.
  • Radionuclide and biological therapies are emerging.
  • We report a 29-year-old man presenting with melaena and diagnosed as having a neuroendocrine tumour of the duodenum together with liver cirrhosis.
  • Standard Whipple's procedure was done and he is doing well at follow-up.
  • [MeSH-major] Carcinoid Tumor / complications. Duodenal Neoplasms / complications. Liver Cirrhosis / diagnosis. Liver Cirrhosis / therapy. Melena / diagnosis. Melena / etiology. Neuroendocrine Tumors / complications
  • [MeSH-minor] Adult. Duodenum / pathology. Endoscopy / methods. Humans. Male. Neoplasm Metastasis. Prognosis. Tomography, X-Ray Computed / methods. Treatment Outcome

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  • (PMID = 18756332.001).
  • [ISSN] 0037-5675
  • [Journal-full-title] Singapore medical journal
  • [ISO-abbreviation] Singapore Med J
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Singapore
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20. Zuetenhorst JM, Valdes Olmos RA, Muller M, Hoefnagel CA, Taal BG: Interferon and meta-iodobenzylguanidin combinations in the treatment of metastatic carcinoid tumours. Endocr Relat Cancer; 2004 Sep;11(3):553-61
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  • [Title] Interferon and meta-iodobenzylguanidin combinations in the treatment of metastatic carcinoid tumours.
  • Interferon (IFN) and meta-iodobenzylguanidin (MIBG) are active in metastatic carcinoids.
  • 131I-MIBG scintigraphy was performed prior to treatment, after 8 weeks of IFN and after unlabelled MIBG.
  • The tumour over non-tumour (T/NT) ratios were quantitatively determined by comparing counts in the centre of the tumour (liver metastases) with those in an adjacent area of normal liver uptake (T/NT1) and with abdominal background area (T/NT2).
  • The absolute uptake in tumour deposits was also increased if compared with the abdominal background (T/NT2: 23% increase after IFN and 83% increase after unlabelled MIBG).
  • The combination produced 91% of patients with stable disease (using World Health Organisation criteria) at computed tomography scan and a biochemical response (a reduction of at least 50% in urinary 5-hydroxyindolacetic acid excretion) in 39%.
  • IFN-alpha did not significantly improve tumour retention of 131I-MIBG.
  • In contrast, unlabelled MIBG significantly improved biodistribution and tumour uptake in 83%.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoid Tumor / drug therapy. Carcinoid Tumor / secondary. Liver Neoplasms / drug therapy. Liver Neoplasms / secondary
  • [MeSH-minor] 3-Iodobenzylguanidine / administration & dosage. Adult. Aged. Disease Progression. Female. Humans. Hydroxyindoleacetic Acid / urine. Interferon-alpha / administration & dosage. Intestinal Neoplasms / drug therapy. Intestinal Neoplasms / pathology. Lung Neoplasms / drug therapy. Lung Neoplasms / pathology. Male. Middle Aged. Recombinant Proteins. Stomach Neoplasms / drug therapy. Stomach Neoplasms / pathology. Survival Rate. Tomography, Emission-Computed

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  • (PMID = 15369454.001).
  • [ISSN] 1351-0088
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Comparative Study; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Interferon-alpha; 0 / Recombinant Proteins; 35MRW7B4AD / 3-Iodobenzylguanidine; 54-16-0 / Hydroxyindoleacetic Acid; 99210-65-8 / interferon alfa-2b
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21. Basaria S, McCarthy EF, Belzberg AJ, Ball DW: Case of an ivory vertebra. J Endocrinol Invest; 2000 Sep;23(8):533-5
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  • The differential diagnosis of an osteoblastic vertebral lesion (ivory vertebra) includes metastatic prostate cancer, lung cancer, lymphoma, osteosarcoma and Paget's disease.
  • He failed to respond to conventional bisphosphate therapy.
  • The review of the original biopsy specimen showed metastatic carcinoid tumor involving the bone marrow.
  • The various features of carcinoid tumors metastasizing to the skeleton are briefly reviewed.
  • [MeSH-major] Carcinoid Tumor / diagnosis. Liver Neoplasms / diagnosis. Spinal Neoplasms / diagnosis
  • [MeSH-minor] Alendronate / therapeutic use. Alkaline Phosphatase / blood. Biopsy. Bone Marrow / pathology. Diagnosis, Differential. Diphosphonates / therapeutic use. Humans. Lumbar Vertebrae. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Metastasis. Osteitis Deformans / drug therapy. Osteoblasts / pathology. Technetium. Tomography, X-Ray Computed

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  • (PMID = 11021770.001).
  • [ISSN] 0391-4097
  • [Journal-full-title] Journal of endocrinological investigation
  • [ISO-abbreviation] J. Endocrinol. Invest.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Diphosphonates; 7440-26-8 / Technetium; EC 3.1.3.1 / Alkaline Phosphatase; OYY3447OMC / pamidronate; X1J18R4W8P / Alendronate
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22. Bodelier AG, Haak HR: [Gastroenteropancreatic neuroendocrine tumours (carcinoid tumours): definition, clinical aspects, diagnosis and therapy]. Ned Tijdschr Geneeskd; 2006 Aug 26;150(34):1868-72
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  • [Title] [Gastroenteropancreatic neuroendocrine tumours (carcinoid tumours): definition, clinical aspects, diagnosis and therapy].
  • [Transliterated title] Gastro-enteropancreatische neuro-endocriene tumoren (carcinoïde tumoren): definitie, kliniek, diagnostiek en therapie.
  • Carcinoid tumours are rare neuroendocrine tumours.
  • In 2000 the WHO developed a new classification which gives a better description of the characteristics and biological behaviour of the tumour.
  • Their advised designation is gastroenteropancreatic neuroendocrine tumour (GEP-NET).
  • In the recent past years new positron emission tomography (PET) tracers have been developed and PET scanning is likely to become an important tool in the near future.
  • Surgical resection is the treatment of first choice for a patient with a GEP-NET.
  • In metastatic disease a number of forms ofpalliative treatment are possible.
  • Cytotoxic chemotherapy seems only to be effective in aggressive, poorly-differentiated tumours.
  • Therapy with somatostatin analogues leads to objective tumour regression in a minority of patients only.
  • New advances in peptide receptor radionuclide therapy using radioactive-labelled somatostatin analoga are showing better results.
  • [MeSH-major] Carcinoid Tumor / diagnosis. Gastrointestinal Neoplasms / diagnosis. Pancreatic Neoplasms / diagnosis
  • [MeSH-minor] Humans. Positron-Emission Tomography / methods. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use

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  • [CommentIn] Ned Tijdschr Geneeskd. 2006 Oct 28;150(43):2401; author reply 2401 [17100134.001]
  • [CommentIn] Ned Tijdschr Geneeskd. 2006 Oct 28;150(43):2401-3; author reply 2403 [17103497.001]
  • (PMID = 16970007.001).
  • [ISSN] 0028-2162
  • [Journal-full-title] Nederlands tijdschrift voor geneeskunde
  • [ISO-abbreviation] Ned Tijdschr Geneeskd
  • [Language] dut
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 51110-01-1 / Somatostatin
  • [Number-of-references] 35
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23. Ducreux M, Baudin E, Schlumberger M: [Treatment strategy of neuroendocrine tumors]. Rev Prat; 2002 Feb 1;52(3):290-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Treatment strategy of neuroendocrine tumors].
  • [Transliterated title] Stratégie de traitement des tumeurs neuro-endocrines.
  • Therapeutic strategy of neuroendocrine tumours is complex, due to their heterogeneity and to the fact that although generally slow growing, a significant proportion demonstrates aggressive tumour growth.
  • Symptomatic carcinoid syndrome and various pancreatic endocrine tumours with symptomatic syndromes are well controlled with somatostatin analogues.
  • Surgery remains the mainstay of treatment if the tumour can be resected.
  • Metastatic pancreatic neuroendocrine tumour are treated when resection is not feasible with combination chemotherapy using adriamycin and streptozotocin, which remains a standard of care.
  • In well differentiated tumour of the gut or the lung there is no clear standard of chemotherapy and treatment vary according to the tumour course.
  • In indolent cases, somatostatin analogues are the best treatment, in case of aggressive tumours chemoembolisation should be preferred when the disease is located or predominant in the liver.
  • Poorly differentiated tumours are treated by combination chemotherapy with etoposide and cisplatin, and surgery has no indication.
  • Gastrinoma and other pancreatic tumours arising in the context of multiple endocrine neoplasia type I disease need a specific therapeutic strategy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Growth Hormone / therapeutic use. Hormones / therapeutic use. Neuroendocrine Tumors / drug therapy. Pancreatic Neoplasms / drug therapy
  • [MeSH-minor] Antibiotics, Antineoplastic / therapeutic use. Chemoembolization, Therapeutic. Doxorubicin / therapeutic use. Gastrinoma / drug therapy. Humans. Malignant Carcinoid Syndrome / drug therapy. Multiple Endocrine Neoplasia. Neoplasm Metastasis. Streptozocin / therapeutic use

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  • (PMID = 11925720.001).
  • [ISSN] 0035-2640
  • [Journal-full-title] La Revue du praticien
  • [ISO-abbreviation] Rev Prat
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Hormones; 5W494URQ81 / Streptozocin; 80168379AG / Doxorubicin; 9002-72-6 / Growth Hormone
  • [Number-of-references] 23
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24. Kunz J, Makek M: [Primary adenocarcinoma of the appendix as differential diagnosis of advanced ovarian carcinoma]. Praxis (Bern 1994); 2006 Aug 16;95(33):1217-25
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  • [Transliterated title] Das primäre Adenokarzinom der Appendix als Differentialdiagnose des fortgeschrittenen Ovarialkarzinoms.
  • They are usually carcinoid tumours that must be distinguished from extremely rare adenocarcinomas.
  • Metastatic mucinous adenocarcinomas of the appendix are only reported as case histories.
  • In clinical terms, the tumours usually manifest themselves as acute appendicitis, as ruptured appendicitis, as a tumour in the right lower abdominal quadrant or as a pelvic tumour, which are generally mistaken for an ovarian tumour with the same sonographic image.
  • The pathologist makes the definitive diagnosis.
  • Surgical therapy of the isolated primary appendiceal carcinoma consists of a hemicolectomy--an appendectomy in favourable cases--and, in the case of a metastasised carcinoma, according to the guidelines for an advanced ovarian or colon carcinoma.
  • The effect of chemotherapy is insufficiently documented.

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  • (PMID = 16939122.001).
  • [ISSN] 1661-8157
  • [Journal-full-title] Praxis
  • [ISO-abbreviation] Praxis (Bern 1994)
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Switzerland
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25. Dworakowska D, Gueorguiev M, Laji K, Grossman AB: Multimodality palliative treatment of (111)In-pentetreotide negative/(123)I-MIBG positive metastatic carcinoid - a case report. Endokrynol Pol; 2008 Jul-Aug;59(4):342-7
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  • [Title] Multimodality palliative treatment of (111)In-pentetreotide negative/(123)I-MIBG positive metastatic carcinoid - a case report.
  • Patients with carcinoid tumours frequently present with metastatic disease.
  • There are only a few therapeutic options for these patients, and the main goal of palliative treatment is to reduce symptoms and thus to improve quality of life.
  • Current therapy includes surgical resection, hepatic artery embolisation, chemotherapy and somatostatin analogue treatment; however, all these options have limitations.
  • It seems probable that therapeutic modalities based on radiopharmaceuticals may provide better therapy, not only in relation to symptom reduction but may also improve patient survival.
  • In this case report we present a 46-year-old woman with a symptomatic carcinoid, who at the time of diagnosis had liver and abdominal lymph node metastases, the primary tumour being located in the terminal ileum. (111)In-pentetreotide scanning was negative, whereas (123)I-MIBG scanning showed high avidity in the tumour tissue.
  • After right hemicolectomy, two courses of (131)I-MIBG treatment were given (12.95 GBq and 12 GBq, respectively).
  • Octreotide therapy was given empirically only for a short time and was stopped because of drug intolerance.
  • The patient underwent tricuspid and pulmonary valve replacement because of her carcinoid heart disease, followed by two courses of embolisation of liver metastases.
  • While (131)I-MIBG therapy reduced the patient's symptoms of flushing and diarrhoea, there has not yet been any effect on tumour response or 5-HIAA production.
  • [MeSH-major] 3-Iodobenzylguanidine / therapeutic use. Carcinoid Tumor / secondary. Carcinoid Tumor / therapy. Ileal Neoplasms / therapy. Palliative Care
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Colectomy. Female. Humans. Liver Neoplasms / secondary. Lymphatic Metastasis. Middle Aged. Octreotide / analogs & derivatives. Octreotide / analysis. Pentetic Acid / analogs & derivatives. Pentetic Acid / analysis

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  • (PMID = 18777505.001).
  • [ISSN] 0423-104X
  • [Journal-full-title] Endokrynologia Polska
  • [ISO-abbreviation] Endokrynol Pol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] 142694-57-3 / SDZ 215-811; 35MRW7B4AD / 3-Iodobenzylguanidine; 7A314HQM0I / Pentetic Acid; RWM8CCW8GP / Octreotide
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26. Kaltsas GA, Mukherjee JJ, Isidori A, Kola B, Plowman PN, Monson JP, Grossman AB, Besser GM: Treatment of advanced neuroendocrine tumours using combination chemotherapy with lomustine and 5-fluorouracil. Clin Endocrinol (Oxf); 2002 Aug;57(2):169-83
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment of advanced neuroendocrine tumours using combination chemotherapy with lomustine and 5-fluorouracil.
  • OBJECTIVE: Combination chemotherapy with the two agents streptozotocin (SZT), which is a nitrosurea, and 5-fluorouracil (5-FU), an alkylating agent, has a long-established role in the treatment of neuroendocrine tumours; however, it is often accompanied by considerable toxicity, and it has not been assessed in a comparative manner with other current chemotherapy regimens.
  • In order to assess the therapeutic response and adverse effects using an alternative nitrosurea, lomustine (CCNU), which has a different side-effect profile, in combination with 5-FU, we have reviewed all patients with neuroendocrine tumours who received this form of treatment in our department.
  • DESIGN: Retrospective analysis of the case notes of patients with metastatic neuroendocrine tumours who received treatment with the combination of CCNU and 5-FU, and who were followed up according to a defined protocol in a given time frame.
  • PATIENTS: Thirty-one patients with metastatic neuroendocrine tumours (18 with carcinoid tumours, five islet-cell tumours, five chromaffin-cell tumours and three medullary carcinoma of the thyroid) treated with the combination of CCNU and 5-FU, and when necessary additional therapy, over a 22-year period, were included in this analysis.
  • MEASUREMENTS: The symptomatic, hormonal and tumoural responses before and after chemotherapy with the combination of CCNU and 5-FU over a median follow-up duration of 25 months (range 9-348 months) were recorded.
  • Of the 31 patients (16 males; median age 52 years, range 20-86 years), eight (four males; median age 61 years, range 30-74 years) were treated with the combination of CCNU and 5-FU alone (Group 1), whereas the other 23 patients (12 males; median age 47 years, range 20-86 years) received additional therapy with other chemotherapeutic regimens, somatostatin analogues, alpha-interferon or radiolabelled meta-iodobenzylguanidine (131I-MIBG) therapy (Group 2).
  • RESULTS: A total of 121 therapeutic cycles was administered (mean 3.9, range 1-14 cycles).
  • None of the patients obtained a complete tumour response.
  • A partial tumour response (not a complete but a 50% or greater reduction of all measurable tumour) was seen in six out of the 29 patients (21%) (four out of eight in Group 1 and two out of 21 in Group 2, respectively).
  • There was no tumour progression in eight out of the 29 patients (27.5%) (one out of eight in Group 1 and seven out of 21 in Group 2, respectively).
  • The overall 5-year survival rate was 42% (95% CI, 17-67%) for all patients and 50% (95% CI, 18-83%) for the carcinoid group alone, according to Kaplan-Meier analysis.
  • Nine out of the 15 (60%) patients with carcinoid tumours who presented with symptoms obtained a symptomatic response, five out of 10 patients (50%) a hormonal response, and four out of 16 (25%) patients a partial tumoural response, respectively.
  • No chemotherapy-related death was recorded.
  • CONCLUSIONS: Chemotherapy with CCNU and 5-FU, either alone or in combination with other therapeutic modalities, produces considerable symptomatic and hormonal improvement and moderate tumour regression/stabilization according to currently accepted WHO criteria, particularly in patients with metastatic gastroenteropancreatic neuroendocrine tumours with minimal adverse effects.
  • It may therefore be a valuable additional therapeutic option, particularly for well-differentiated carcinoid and islet-cell tumours, but mainly reserved for when there is no response or progression of the disease after currently available first-line treatment with somatostatin analogues or radiopharmaceuticals.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neuroendocrine Tumors / drug therapy. Neuroendocrine Tumors / secondary
  • [MeSH-minor] Adult. Aged. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. Follow-Up Studies. Humans. Lomustine / administration & dosage. Male. Middle Aged. Retrospective Studies. Survival Rate

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  • (PMID = 12153595.001).
  • [ISSN] 0300-0664
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 7BRF0Z81KG / Lomustine; U3P01618RT / Fluorouracil
  • [Number-of-references] 50
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27. Toumpanakis C, Standish RA, Baishnab E, Winslet MC, Caplin ME: Goblet cell carcinoid tumors (adenocarcinoid) of the appendix. Dis Colon Rectum; 2007 Mar;50(3):315-22
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  • [Title] Goblet cell carcinoid tumors (adenocarcinoid) of the appendix.
  • Right hemicolectomy was performed in all except one, who subsequently developed metastases.
  • Ki67 index was greater than 20 percent in all of them, while in only one with local tumor.
  • Combination chemotherapy with either cisplatin plus etoposide or with 5-fluorouracil, cisplatin, and streptozotocin was administered to all patients with metastases resulting in temporary stabilization of disease.
  • Ki67 index appears to predict tumor behavior.
  • Chemotherapy may have efficacy in metastatic disease, however, more data are required to determine this and the optimal regimen.
  • [MeSH-major] Appendiceal Neoplasms / diagnosis. Carcinoid Tumor / diagnosis
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Appendectomy. Biomarkers, Tumor / analysis. Cisplatin / administration & dosage. Colectomy. Combined Modality Therapy. Diagnosis, Differential. Etoposide / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Immunohistochemistry. Ki-67 Antigen / analysis. Male. Middle Aged. Neoplasm Metastasis. Retrospective Studies. Streptozocin / administration & dosage


28. Tanvetyanon T, Choudhury AM: Hypocalcemia and azotemia associated with zoledronic acid and interferon alfa. Ann Pharmacother; 2004 Mar;38(3):418-21
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  • OBJECTIVE: To describe severe hypocalcemia and acute renal failure associated with zoledronic acid and interferon alfa in a patient with metastatic carcinoid tumors.
  • CASE SUMMARY: A 39-year-old white man with metastatic carcinoid tumor tolerated treatment with subcutaneous long-acting octreotide monthly and interferon alfa 6 million units 3 times weekly for 6 months.
  • Although the first infusion went well, the patient developed severe hypocalcemia and acute renal failure after the second zoledronic infusion.
  • DISCUSSION: Bisphosphonates may infrequently cause symptomatic hypocalcemia, especially among patients who have vitamin D deficiency or hypoparathyroidism or receive treatment with an aminoglycoside.
  • Since therapeutic indications of both interferon alfa and zoledronic acid continue to expand, clinicians should be aware of these serious adverse reactions and potential interaction.
  • Supportive treatment with hydration, calcium supplement, and oral calcitriol resulted in resolution of hypocalcemia, but only partial improvement of azotemia.
  • CONCLUSIONS: In our patient with metastatic carcinoid tumor, treatment with zoledronic acid and interferon alfa was associated with symptomatic hypocalcemia and acute renal failure.
  • [MeSH-minor] Adult. Carcinoid Tumor / drug therapy. Humans. Male

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  • (PMID = 14970365.001).
  • [ISSN] 1060-0280
  • [Journal-full-title] The Annals of pharmacotherapy
  • [ISO-abbreviation] Ann Pharmacother
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Diphosphonates; 0 / Imidazoles; 0 / Interferon-alpha; 6XC1PAD3KF / zoledronic acid
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29. Gerencer RZ, Patel U, Hunter C, Heffernan JT: The role of endoscopic sinus surgery in the diagnosis and treatment of metastatic orbital carcinoid tumors. Ear Nose Throat J; 2007 Mar;86(3):157-61
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  • [Title] The role of endoscopic sinus surgery in the diagnosis and treatment of metastatic orbital carcinoid tumors.
  • Carcinoid tumor metastatic to the orbit is a rare occurrence.
  • We report such a case in a patient with a carcinoid metastasis that was found in the medial rectus muscle.
  • We also discuss the treatment of metastatic orbital carcinoid in the hope that we will increase awareness of the utility of transnasal endoscopy in facilitating both the diagnosis and treatment of posteromedial orbital pathology.
  • [MeSH-major] Carcinoid Tumor / secondary. Carcinoid Tumor / surgery. Endoscopy / methods. Orbital Neoplasms / secondary. Orbital Neoplasms / surgery
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Female. Humans. Liver Neoplasms / drug therapy. Liver Neoplasms / pathology. Middle Aged

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  • (PMID = 17427777.001).
  • [ISSN] 0145-5613
  • [Journal-full-title] Ear, nose, & throat journal
  • [ISO-abbreviation] Ear Nose Throat J
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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30. Plöckinger U, Wiedenmann B: [Neuroendocrine tumours of the gastrointestinal tract]. Z Gastroenterol; 2004 Jun;42(6):517-27
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  • [Transliterated title] Neuroendokrine Tumoren des Gastrointestinaltrakts.
  • Abdominal ultrasound (US), computed tomography (CT), magnetic resonance tomography (MRT) and somatostatin receptor scintigraphy (SRS) are used for localisation of the primary tumour and metastasis.
  • For localised tumours surgery is the first line treatment.
  • In metastatic disease symptomatic therapy, biotherapy and chemotherapy are available.
  • Cytoreductive therapy such as embolisation, chemoembolisation, thermo- or cryotherapy, or radio-receptor therapy are additional options.
  • An increased chromogranin-A plasma concentration or 5-hydroxyindoleacetic acid 24-h urinary excretion indicates the neuroendocrine origin of the tumour or the possibility of a carcinoid syndrome, respectively.
  • Surgical therapy prolongs survival but is rarely curative.
  • Biotherapy is effective as symptomatic therapy.
  • Chemotherapy is less effective in midgut tumours compared to foregut tumours.
  • Cytoreductive strategies (chemoembolisation, thermo- or cryotherapy, cytoreductive surgery) and radio-receptor therapy may offer new therapeutic options.
  • However, their definitive value has yet to be defined.
  • [MeSH-major] Endoscopy, Gastrointestinal / methods. Gastrointestinal Neoplasms / diagnosis. Gastrointestinal Neoplasms / therapy. Neuroendocrine Tumors / diagnosis. Neuroendocrine Tumors / therapy. Patient Care Management / methods
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy / methods. Diagnosis, Differential. Humans. Palliative Care / methods. Practice Guidelines as Topic. Practice Patterns, Physicians'. Prognosis. Treatment Outcome

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  • (PMID = 15190448.001).
  • [ISSN] 0044-2771
  • [Journal-full-title] Zeitschrift für Gastroenterologie
  • [ISO-abbreviation] Z Gastroenterol
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 38
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